Lesson 4: Biological therapies for SZ Flashcards
most common treatment
antipsychotic drugs, typical and atypical
typical antipsychotics
-dopamine antagonists, reduce the effects of dopamine and reduces the symptoms of sz
-bind to but do not stimulate dopamine receptors, blocking their actions, reducing the positive symptoms of sz
named typical antipsychotic
-chlorpromazine
-effective sedative used to calm patients
-faster absorbed in syrup form than in tablet
-maximum dosage is 1000mg, starts smaller and gradually increased from about 400mg to 800mg
atypical antipsychotics
-emerged in 1970s, used to improve effectiveness of typical antipsychotics and minimise the side effects occurring from typical antipsychotics
-beneficial effect on negative symptoms of and on cognitive impairment
-suitable for treatment resistant patients
-temporarily occupy dopamine receptors and then rapidly disassociate to allow normal dopamine transmission, rapid disassociation that responsible for lower levels of side effects
named atypical antipsychotics
clozapine and risperidone
clozapine
-developed in 1960s, trialed in 70s, withdrawn after patients dying with agranulocytosis
-came back in 80s as seen as more effective than typical, used as alternative if typical didn’t work
-patients given regular blood tests to avoid agranulocytosis
-not available as injection, only syrup or tablet
-dosage between 300mg - 450mg per day
other clozapine effects
-acts on serotonin and glutamate receptors
-working on other neurotransmitters helps to reduce depression and anxiety and improve cognitive functioning
-improves mood, generally given to patients at high risk of suicide
risperidone
-emerged in 1990s as an attempt to reduce serious side effects of clozapine, but still be as effective
-can be taken as syrup, tablet or injection
-dosage of 4mg to 8mg, maximum dosage of 12mg
-binds more efficiently, smaller doses required
bio therapies strengths
-Thorney et al (2003) compared the use of chlorpromazine with a placebo, data from 13 trials with a total of 1121 participants showed that chlorpromazine was associated with reduced symptoms and better overall functioning.
-Data from 3 trials with a total of 512 participants showed that relapse rate was lower with chlorpromazine
-study shows that typical antipsychotics were effective in reducing the symptoms of sz compared to a placebo, showing drug therapy is appropriate and effective for treating sz
-Meltzer (2012) concluded clozapine is more effective than typical antipsychotics and other atypical antipsychotics in treating sz, clozapine seen as effective in 30-50% where typical antipsychotics had failed
-study shows that clozapine is appropriate and effective to use as sz treatment
-Leuch et al (2012) carried out a meta-analysis of 65 studies published between 1959 and 2011 and involving nearly 600 patients
-some patients taken off their antipsychotic medication and given placebos. within 12 months 64% of those patients who had been given placebo relapsed, whereas only 27% relapsed when on antipsychotics
-the results show that antipsychotic medication is both effective and appropriate in preventing a schizophrenic from relapsing
bio therapies weaknesses
-serious side effects, dizziness, agitation, sleepiness, stiff jaw, weight gain, itchy skin, tardive dyskinesia, neuro malignant syndrome, lead to high temperature, delirium, coma, death, may occur in 0.1%-2% of schizophrenics
-Healy (2012) suggested that some successful drug trials have had their data published multiple times, exaggerating the effectiveness
-because drugs also have powerful calming effects they appear successful, but does not really show how
-ethical issues, lack of consent, might not be in right frame of mind to give fully informed, have severe side effects so brings to question the extent of harm and whether drug effects are reversible
